Topical prostaglandin fixed combinations in UK primary care: observational study using data from the health improvement network

Eur J Ophthalmol. 2012 May-Jun;22(3):376-87. doi: 10.5301/ejo.5000068.

Abstract

Purpose: To describe the use of 3 prostaglandin/timolol fixed combinations (FCs) in UK primary care, to summarize characteristics of recipients, and to assess 12-month persistence.

Methods: This retrospective cohort study included first-time recipients of latanoprost/timolol FC, bimatoprost/timolol FC, or travoprost/timolol FC treated between April 1, 2007, and November 30, 2008, identified in The Health Improvement Network database, a large database of anonymized longitudinal electronic medical records of patients treated in UK primary care. Eligible patients were = 18 years old at the index date (date of first prescription). Persistence, defined as a gap =60 days between consecutive prescriptions, was assessed through 12 months post-index for each cohort (Cox proportional hazards models).

Results: A total of 2,015 patients were included: latanoprost/timolol FC, n = 898 (44.6%); bimatoprost/timolol FC, n = 733 (36.4%); travoprost/timolol FC, n = 384 (19.1%). The mean age was approximately 72 years across cohorts (p = 0.792). Glaucoma was the diagnosis for >90% of patients in each cohort. Twelve-month persistence was similar across treatments: latanoprost/timolol FC: 38.2%; bimatoprost/timolol FC: 38.6%; travoprost/timolol FC: 38.3% (p = 0.985). Mean time to therapy change for nonpersistent patients was also similar: 143.3 ± 89.8, 151.0 ± 87.9, and 151.8 ± 87.7 days, respectively (p = 0.095). Among persistent patients, additional therapy was prescribed for 36.2%, 41.7%, and 41.5% of patients, respectively. Among nonpersistent patients, 64.0%, 70.4%, and 69.2%, respectively, restarted the index therapy.

Conclusions: The largest proportion of first-time recipients of prostaglandin/beta-blocker FC products treated in UK primary care was prescribed latanoprost/timolol FC. Twelve-month persistence was similar (<40%) across the 3 FCs evaluated.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Topical
  • Adult
  • Aged
  • Aged, 80 and over
  • Amides / administration & dosage*
  • Antihypertensive Agents / administration & dosage*
  • Bimatoprost
  • Cloprostenol / administration & dosage
  • Cloprostenol / analogs & derivatives*
  • Databases, Factual
  • Drug Combinations
  • Female
  • Glaucoma / drug therapy*
  • Humans
  • Intraocular Pressure / drug effects
  • Latanoprost
  • Male
  • Middle Aged
  • Ocular Hypertension / drug therapy
  • Ophthalmic Solutions
  • Practice Patterns, Physicians'*
  • Primary Health Care
  • Prostaglandins F, Synthetic / administration & dosage*
  • Retrospective Studies
  • Timolol / administration & dosage*
  • Travoprost
  • United Kingdom
  • Young Adult

Substances

  • Amides
  • Antihypertensive Agents
  • Drug Combinations
  • Ophthalmic Solutions
  • Prostaglandins F, Synthetic
  • Cloprostenol
  • Latanoprost
  • Timolol
  • Bimatoprost
  • Travoprost